Individual ProviderVineeta BasutkarNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address200 Ucla Medical Plz Ste 214, Los Angeles, CA 90095-8358(310) 794-7788PECOS EnrollmentBased on the most recent information from CMS, provider Vineeta Basutkar is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 11 days ago.Profile DetailsProvider ID1023487766Provider TypeIndividualFull NameBasutkar, VineetaGenderFemaleSole ProprietorYesEnumeration Date9/23/2015Last Updated12/27/2019Contact InformationPractice LocationPractice Address200 Ucla Medical Plz Ste 214, Los Angeles, CA 90095-8358Phone(310) 794-7788Fax(310) 794-4337Mailing LocationMailing Address5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LA2100XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense95001544CaliforniaCode163W00000XDescriptionRegistered NurseNursing Service ProvidersLicense695769California